From the outset, Wolozin and colleagues1 assert that hypercholesterolemia is associated with increased risk of Alzheimer disease (AD). That premise, of course, sets up their study hypothesis regarding the putative protective effects of statin-class lipid-lowering medications on the development of AD. However, while recent research suggests a role for lipids in AD, the manner in which the article deals with this topic is, at best, misleading. Molecular studies are revealing a complex but indirect role for cholesterol transport and membrane dynamics in the pathophysiology of AD. Too little rather than too much cholesterol in neural membranes appears to increase vulnerability to dysfunction.2 Similarly, low, not high, serum cholesterol concentrations have been found to predict cognitive decline in prospective studies of aging American twins3 and elderly Finns.4 Thus, only a fraction of published evidence supports the article's opening premise.5